Hi I have gone through your sonogram findings. Bright small kidneys with loss of corticomedullary differentiation means grade 4 kidney disease.it means near total loss of functioning nephrons in it. Due to it high blood pressure and fluid tend to accumulate in body.you need to consult nephrologist to evaluate cause and to know how much excreatory function left. Dialysis is required to eliminate toxins from body. Ome times renal transplant is advisable If you get compatable donor .its all planned only when after assessing the renal function and depend on its severity. Thank u Regards Vasundhara